In recent years, cigarette smoking prevalence has declined in many states; however, there has been relatively little change in the prevalence of current smokeless tobacco use or concurrent use of cigarettes and smokeless tobacco in most states, and in some states prevalence has increased. CDC analyzed prevalence estimates from the 2014 Behavioral Risk Factor Surveillance System to assess state-specific prevalence estimates of current use of cigarettes, smokeless tobacco, and cigarette and/or smokeless tobacco (any cigarette/smokeless tobacco use) among U.S. adults.

Current cigarette smoking ranged from 9.7% (Utah) to 26.7% (West Virginia). Current smokeless tobacco use ranged from 1.4% (Hawaii) to 8.8% (Wyoming). Current use of any cigarette and/or smokeless tobacco product ranged from 11.3% (Utah) to 32.2% (West Virginia). Disparities in tobacco use by sex and race/ethnicity were observed; any cigarette and/or smokeless tobacco use was higher among males than females in all 50 states. By race/ethnicity, non-Hispanic whites had the highest prevalence of any cigarette and/or smokeless tobacco use in eight states, followed by non-Hispanic other races in six states, non-Hispanic blacks in five states, and Hispanics in two states; the remaining states did not differ by race/ethnicity.

These findings highlight the importance of enhanced implementation of evidence-based strategies to help smokers and other tobacco users quit completely. Cessation programs involving both medication and counseling, in combination with comprehensive tobacco control measures, as recommended by the World Health Organization and CDC's Best Practices for Comprehensive Tobacco Control Programs, can help to reduce tobacco-related morbidity and mortality.